Provider Demographics
NPI:1457810475
Name:TOLIA, SANIKA (DO)
Entity Type:Individual
Prefix:
First Name:SANIKA
Middle Name:
Last Name:TOLIA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2815 PARKWOOD LN
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-1350
Mailing Address - Country:US
Mailing Address - Phone:630-280-1849
Mailing Address - Fax:
Practice Address - Street 1:1875 W DEMPSTER ST
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1186
Practice Address - Country:US
Practice Address - Phone:847-698-3600
Practice Address - Fax:847-698-5517
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-19
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.074043207R00000X
390200000X
IL036.160963207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program